Organization
EXODUS HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN GREEN (PRESIDENT)
(760) 845-4876
Entity
Organization
Contact information
Practice address
6445 UNIVERSITY AVE, SAN DIEGO, CA 92115-5808
(760) 845-4876
Mailing address
6445 UNIVERSITY AVE, SAN DIEGO, CA 92115-5808
(760) 845-4876
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W19528
MEDICARE GROUP NUMBER
CA
Enumeration date
08/21/2007
Last updated
08/21/2007
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